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Medicare Plans for Individuals

Medicare health coverage through Blue Cross and Blue Shield of Illinois includes Medicare Advantage with Prescription Drug plans (MAPD), stand-alone Medicare Prescription Drug Plans (PDP), and Medicare Supplement Insurance Plans.

Producers selling our Medicare products have a large variety of options to share with their clients and a host of marketing and sales tools at the ready when they work with us.

Blue Cross Medicare Advantage Plans

Our HMO, HMO-POS and PPO plans bundle cost-saving and value-added options with Original Medicare benefits. Here are some plan highlights. (Producers must be certified to sell MAPD plans.)

Blue Cross Medicare Advantage (HMO)SM

  • Typically have lower or $0 monthly premiums
  • Care is handled by one primary care provider (PCP)
  • Costs will be as low as possible when using in-network providers
  • Member may need a referral from PCP to visit a specialist
  • Plans may or may not cover prescription drugs

Blue Cross Medicare Advantage (HMO-POS)SM

  • A $0 monthly premium option is available
  • Flexibility to see doctors outside of the plan network in some cases
  • A predetermined copay rate, no coinsurance, to see out-of-network providers
  • Plans may or may not cover prescription drugs

Blue Cross Medicare Advantage (PPO)SM

  • Tend to have higher monthly premiums. A $0 monthly premium option is available.
  • Members are not required to select a PCP
  • Freedom to use providers outside-of-network but members may pay higher copays and coinsurance
  • Members save money if they use in-network providers
  • Plans may or may not cover prescription drugs

Blue Cross MedicareRx Plans

Blue Cross MedicareRx plans go beyond Original Medicare to offer coverage for prescription drugs. Whether your clients have a few prescriptions or a lot, BCBSIL offers plans that can work for their health care needs and budget. Here are highlights of each plan. (Producers must be certified to sell PDP plans.)

Blue Cross MedicareRx Basic (PDP)SM

  • Nationwide Pharmacy Network
  • Annual deductible applies to all Tiers
  • No Gap coverage
  • Narrow Formulary

Blue Cross MedicareRx Choice (PDP)SM

  • Nationwide Pharmacy Network
  • Annual deductible applies to Tiers 3, 4, and 5
  • No Gap coverage
  • Essential Formulary

Blue Cross MedicareRx Value (PDP)SM

  • Nationwide Pharmacy Network
  • Annual deductible applies to Tiers 3, 4, and 5
  • Gap coverage for Tier 1 Only
  • Broad Formulary

Medicare Supplement Insurance Plans

We offer a wide variety of Medicare Supplement Insurance Plans. They fall into two main types:

  • Medicare Supplement Insurance Guaranteed Issue Plans do not require underwriting.
  • Medicare Supplement Insurance Secure Plans offer the same benefit as standard plans but have lower rates if you can pass a series of health-related screening questions.

Learn more about each here.

Last Updated: Nov. 27, 2023